The effect of oral Paracetamol compared to oral Pregabalin for postoperative pain relief following Anterior cruciate ligament reconstruction surgeries under subarachnoid block - A prospective randomized trial.

Abstract

Introduction: Poor postoperative pain control after spinal anaesthesia impairs the functional recovery and increases the requirement of analgesics postoperatively. Good analgesia after the surgery is essential for early mobilization and rehabilitation following anterior cruciate ligament (ACL) reconstruction surgeries. Pregabalin and paracetamol are commonly used non-opioid analgesics in multimodal pain management perioperatively, but studies comparing their preoperative use in ACL reconstruction surgeries are very limited. Objectives: To compare the analgesic efficacy of preoperative oral pregabalin and oral paracetamol in patients undergoing ACL reconstruction under subarachnoid block, and to study the associated hemodynamic changes and any adverse effects. Methodology: In this prospective, randomized, double-blind study, 150 adult patients (ASA I–II) scheduled for ACL reconstruction under spinal anaesthesia were allocated to receive either oral pregabalin 75 mg or oral paracetamol 1 g two hours before surgery. Postoperative pain was assessed using the Visual Analogue Scale (VAS) for 24 hours. Duration of analgesia, need for rescue pain medications, hemodynamic parameters, and any adverse effects were recorded. Results: Preoperative pregabalin resulted in significantly lower postoperative VAS scores and prolonged duration of analgesia compared to paracetamol. Rescue analgesic requirement was reduced in the pregabalin group. Hemodynamic parameters were comparable between groups and no significant adverse effects were observed in either group. Conclusion: Preoperative oral pregabalin 75 mg provides superior postoperative analgesia with reduced rescue analgesic requirements compared to oral paracetamol 1 g in ACL reconstruction under spinal anaesthesia, supporting its role in multimodal perioperative pain management.